Myelopathy associated with Hashimoto's disease
- Second Department of Internal Medicine and Clinical Laboratory, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari-ku, Osaka,537–8511, Japan
- Dr Tsutomu Azuma azumat{at}yahoo.co.jp
Encephalopathy associated with Hashimoto's disease was first reported by Brain et al in 1966.1 Hashimoto's encephalopathy is a steroid responsive relapsing disorder associated with Hashimoto's disease that often presents with stroke-like episodes, myoclonus, and cognitive impairment. Diagnostic testing usually shows a euthyroid state with increased thyroid autoantibodies, increased CSF protein, and EEG abnormalities.2 3 We present the first case of myelopathy associated with Hashimoto's disease, followed 2 months later by encephalopathy.
A 70 year old housewife was admitted to our hospital on 28 July 1997. Her leg had felt heavy for a month, and she was unable to walk for several days before admission due to weakness in the left leg. She had been diagnosed with Hashimoto's disease at the age of 57 and treated with thyroxin. On January 11 1988, she had developed dysesthesia and weakness in the left arm and leg. Brain CT, radiography of the cervical spine, and CSF findings were normal at this time. She gradually recovered after this. On 31 January 1997, she was experiencing weakness in her left leg, which gradually disappeared over 2 months.
On physical examination, the blood pressure was 114/62 mm Hg. She had marked scoliosis. Neurological examination indicated a decrease of pain and temperature sensations on the right …
